Abstract:
BACKGROUND AND AIMS:Dysplasia within sessile serrated polyps (SSPs) is difficult to detect and may be mistaken for an adenoma, risking incomplete resection of the background serrated tissue, and is strongly implicated in interval cancer after colonoscopy. The use of endoscopic imaging to detect dysplasia within SSPs has not been systematically studied. METHODS:Consecutively detected SSPs ≥8 mm in size were evaluated by using a standardized imaging protocol at a tertiary-care endoscopy center over 3 years. Lesions suspected as SSPs were analyzed with high-definition white light then narrow-band imaging. A demarcated area with a neoplastic pit pattern (Kudo type III/IV, NICE type II) was sought among the serrated tissue. If this was detected, the lesion was labeled dysplastic (sessile serrated polyp with dysplasia); if not, it was labeled non-dysplastic (sessile serrated polyp without dysplasia). Histopathology was reviewed by 2 blinded specialist GI pathologists. RESULTS:A total of 141 SSPs were assessed in 83 patients. Median lesion size was 15.0 mm (interquartile range 10-20), and 54.6% were in the right side of the colon. Endoscopic evidence of dysplasia was detected in 36 of 141 (25.5%) SSPs; of these, 5 of 36 (13.9%) lacked dysplasia at histopathology. Two of 105 (1.9%) endoscopically designated non-dysplastic SSPs had dysplasia at histopathology. Endoscopic imaging, therefore, had an accuracy of 95.0% (95% confidence interval [CI], 90.1%-97.6%) and a negative predictive value of 98.1% (95% CI, 92.6%-99.7%) for detection of dysplasia within SSPs. CONCLUSIONS:Dysplasia within SSPs can be detected accurately by using a simple, broadly applicable endoscopic imaging protocol that allows complete resection. Independent validation of this protocol and its dissemination to the wider endoscopic community may have a significant impact on rates of interval cancer. (Clinical trial registration number: NCT03100552.).
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Tate DJ,Jayanna M,Awadie H,Desomer L,Lee R,Heitman SJ,Sidhu M,Goodrick K,Burgess NG,Mahajan H,McLeod D,Bourke MJdoi
10.1016/j.gie.2017.06.031subject
Has Abstractpub_date
2018-01-01 00:00:00pages
222-231.e2issue
1eissn
0016-5107issn
1097-6779pii
S0016-5107(17)32079-5journal_volume
87pub_type
杂志文章abstract:BACKGROUND:A trucut needle biopsy device that can be used to obtain specimens from the pancreas and other perigastric organs under EUS guidance has been developed and successfully tested in animals. Moreover, EUS-guided trucut needle biopsy has been used safely in humans and appears to provide more accurate results tha...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)02538-0
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Although endoscopic hemoclip therapy is widely used in the treatment of GI bleeding, there are few prospective trials that assess its efficacy. This study evaluated the efficacy and safety of hemoclip placement and distilled water injection for the treatment of high-risk bleeding ulcers. METHODS:Seventy-nin...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mge.2003.103
更新日期:2003-03-01 00:00:00
abstract::In a retrospective study, 33 achalasia patients were treated with dilation therapy using large diameter mercury bougienage (mean, 56 French) and/or pneumatic balloon dilation. Mean follow-up time was 35 months. Mercury bougienage, performed in 20 patients, was successful in 10 (50%) with no complications. Pneumatic di...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(91)70614-7
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND AND AIMS:EMR and endoscopic submucosal dissection (ESD) are widely accepted in Asia for treatment of early gastric cancer (EGC). Few studies have examined lymph node (LN) metastasis of EGC in Western populations. We sought to examine EGC and LN metastasis in a heterogeneous Western population. METHODS:Patie...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.10.039
更新日期:2016-06-01 00:00:00
abstract::The initial treatment of choice in patients with achalasia is balloon dilation. Heretofore, this procedure was performed on an in-hospital basis resulting in high patient cost. This study evaluated the safety and efficacy of pneumatic dilation as an outpatient procedure. Sixty-one procedures were performed on 50 patie...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)70964-9
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Confocal laser endomicroscopy (CLE) allows real-time in vivo histologic evaluation of GI lesions. To our knowledge, there is no reported prospective study comparing endoscopic and optical biopsy using CLE before endoscopic submucosal dissection (ESD) with post-ESD histopathology. OBJECTIVE:We compared endos...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2011.05.005
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Acute appendicitis is one of the most common causes of acute abdomen. Despite recent advances in radiologic imaging, the diagnosis of acute appendicitis may be difficult on occasion. The aims of this study were to describe the colonoscopic features of appendicitis and to determine whether colonoscopy can be ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(02)70036-9
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Celiac ganglia have not been previously identified by EUS. OBJECTIVE:To assess whether celiac ganglia can be detected by EUS and to define their characteristics. DESIGN:Retrospective review followed by prospective study. METHODS:Retrospective characterization was performed of all celiac ganglia that were ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.01.071
更新日期:2006-07-01 00:00:00
abstract::The use of endoscopic ultrasonography (EUS) in the diagnosis of submucosal upper gastrointestinal tract lesions was examined in 308 patients. Two-hundred ten submucosal tumors, 89 cases of esophagogastric varices, and 9 cases of non-Hodgkin's lymphoma were found. EUS images were interpreted based upon a five-layer EUS...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)71010-3
更新日期:1990-03-01 00:00:00
abstract::Electronic chromoendoscopy technologies provide image enhancement and may improve the diagnosis of mucosal lesions. Although strides have been made in standardization of image characterization, especially with NBI, further image-to-pathology correlation and validation are required. There is promise for the development...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/j.gie.2014.06.020
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND AND AIMS:Unresectable malignant biliary strictures are generally managed by palliative stent placement for drainage of biliary tree. Recently, radiofrequency ablation (RFA) has been used to improve the patency of biliary stents in these patients. Several studies have evaluated the effectiveness of biliary st...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.gie.2017.10.029
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:When choosing submucosal injection solutions for EMR, tissue damage should be considered, as well as the lesion-lifting ability. The objective of the study was to find out the potential tissue damage of submucosal injection solutions. METHODS:The submucosal injection solutions examined were the following: n...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.07.052
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:EUS-FNA can be used to accurately diagnose and stage GI and pulmonary neoplasms. This study evaluated the performance characteristics of a new compact linear EUS system during EUS-FNA. METHODS:A total of 37 patients enrolled in this prospective pilot study underwent clinically indicated EUS-FNA and/or celia...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(03)70038-8
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Use of an echocolonoscope to examine patients with inflammatory bowel disease is technically difficult. Catheter probe assisted endoluminal ultrasonography (US) may be a feasible alternative. METHODS:Determination of demographic information and clinical disease activity was followed by colonoscopy with biop...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)70342-1
更新日期:1999-07-01 00:00:00
abstract::Laparoscopy was performed in 40 patients with gastric carcinoma, whose lesions were otherwise considered amenable to operation, in order to more accurately stage the disease and ascertain the prospect of resectability. Laparoscopy disclosed hitherto unrecognized distant metastases in 5 cases (12.5%) and locally advanc...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(91)70776-1
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Pentoxifylline can ameliorate pancreatitis in animal models because of its anti-tumor necrosis factor properties. OBJECTIVE:Our purpose was to study the safety and efficacy of pentoxifylline in the prevention of post-ERCP pancreatitis. DESIGN:Patients due to undergo ERCP for various indications were random...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2007.03.1045
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Pancreatic/peripancreatic tuberculosis (TB) is a very rare clinical entity, even in countries with high incidences of TB. The diagnosis of pancreatic/peripancreatic TB with EUS-guided FNA (EUS-FNA) remains a diagnostic challenge because of limitations of the endoscopists' expertise on this condition. OBJECT...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.10.007
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND AND AIMS:Endoscopic multiband mucosectomy (EMBM) has been used to treat early Barrett's esophagus and esophagogastric junction neoplasia, yet it is seldom reported for the treatment of early esophageal squamous cell neoplasia. Here we retrospectively evaluated the feasibility, safety, and efficacy of EMBM fo...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2016.04.015
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Appropriateness of indications is essential to the rational utilization of resources. The aim of this study was to evaluate the appropriate use of colonoscopy in an open access system and to assess whether the American Society for Gastrointestinal Endoscopy (ASGE) guidelines are useful in clinical practice. ...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1067/mge.2000.106683
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Nonvariceal upper GI bleeding (NVUGIB) that occurs in patients already hospitalized for another condition is associated with increased mortality, but outcome predictors have not been consistently identified. OBJECTIVE:To assess clinical outcomes of NVUGIB and identify predictors of mortality from NVUGIB in ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2013.10.009
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Deep cannulation of the dorsal duct in patients with pancreas divisum may not be possible, even for the experienced endoscopist. This is a description of a technique to facilitate access to the dorsal duct. METHODS:Patients undergoing dorsal ductography in whom endoscopic therapy was indicated and in whom a...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.115474
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Previous reports on percutaneous endoscopic cecostomy (PEC) for the delivery of antegrade continence enema (ACE) in adults have been presented in the form of case reports. Heretofore the tubes used in the pull method of PEC have been thick bolster catheters. The author performed PEC by using the introducer m...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.12.035
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Photodynamic therapy appears to be effective in ablating high-grade dysplasia in Barrett's esophagus. Our aim was to identify the most effective and cost-effective strategy for managing high-grade dysplasia in Barrett's esophagus without associated endoscopically visible abnormalities. METHODS:By using deci...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02167-4
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:ERCP experience in pancreatic disorders in children is limited. OBJECTIVE:This study evaluated the utility and efficacy of ERCP in children with pancreatic diseases at a tertiary care referral center. PATIENTS AND SETTINGS:Consecutive patients 18 years of age and younger who underwent ERCP for pancreatic d...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2013.07.060
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Bile leak is among the most common complications of cholecystectomy. Endoscopic therapy is empiric; a systematic approach to management of bile leak has not been established. METHODS:The severity of bile leak was classified by endoscopic retrograde cholangiography into low grade (leak identified only after ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)01892-9
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:En bloc EMR is performed in Japan as a curative treatment for early stage gastric cancer. However, current methods of EMR are technically difficult and require proficiency in determining the extent of the cancer. This study assessed the feasibility of a new method to obviate these problems and to facilitate ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)01285-4
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Peptic ulcer disease is considered the cause of upper-GI bleeding in 50% of cases. A recent decline in the proportion of cases of upper-GI bleeding because of a peptic ulcer was noted by us. The objectives of this study were to evaluate the frequency of peptic ulcer in patients with upper-GI bleeding and the...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)00181-6
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Patients with hereditary hemorrhagic telangiectasia (HHT) often present with recurrent anemia because of epistaxis or GI bleeding in relation to telangiectases mostly located in the stomach or small bowel. Capsule endoscopy is considered a major diagnostic tool for small-bowel diseases, but the impact of cap...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2009.11.004
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:New therapies are needed for pancreatic cancer. OBJECTIVE:To determine the feasibility and safety of a new endoscopic treatment. Secondary endpoints were to determine effects on tumor growth measured with CT scan and to find the overall survival. DESIGN:A cohort study of patients with local progression of ...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/j.gie.2012.08.006
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Management of anastomotic biliary strictures after liver transplantation deserves optimization. OBJECTIVE:To evaluate placement and removal of partially covered self-expandable metal stents (PCSEMSs) in this setting. DESIGN:Prospective, multicenter, uncontrolled study. SETTING:Three French academic hospit...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2010.08.016
更新日期:2010-12-01 00:00:00